Evaluation of factors that affecting mortality in urgent redo-laparotomies

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Öz

Objective: The aim of this study was to investigate the factors that affect mortality in patients undergoing Urgent abdominal redo-laparatomies (UARLs) and to analyze the common indications and operative,demograhic and clinical characteristics in UARLs.

Material and Methods: Our study was designed as a retrospective, observational and multi-centric study. A total of 155 patients from two separate clinics undergoing urgent, unplanned redo-laparatomy were included in the study. The data obtained from all clinics were collected and and the relations of the demographic, clinical and operational factors with the mortalities of primary surgery and multiple UARLs were analyzed.

Results: Mortality was observed in 42 (27%) patients. The most frequent causes of mortality were sepsis and multi-system organ failure in 23 (53.4%) patients. The relationships between the number of redo-laparotomy presence of blood transfusion, older age,classification of surgery and mortality were significant (p<0.05).

Conclusion: Sepsis and multi-organ failure were the most frequent cause of mortality in our study as well, with a rate of 53.4 %. No significant relationship was observed between mortality and initial surgery under emergency conditions and presence of comorbidity. Redolaparatomies inevitable in some clinical situations. Since multiple redolaparatomies are associated with mortality , it is necessary to avoid complications during initial surgery to reduce UARLs. Major surgery operation UARLs in elderly people should be avoided. Finally, the surgeon should also make the UARLs decision at the right time.